Abstract
Purpose
The aim of the study is to evaluate omission of routine use of drains after major gynaecology oncology cancer surgery in day-to-day practice.
Methods
The study consisted of 130 gynaecology cancer patients in two groups, study group (with no drains) and control group (with drains). The primary aim was to detect whether omitting drains leads to delay in detection of post-operative complications and overall complication rate between the two groups with the secondary aim of finding difference in length of hospital stay.
Results
There no patient in either group who required re-exploration for bleeding, bowel or urologic injury. There was statistical non-significant difference in complication rate, 22% versus 30% in study vs. control group, respectively. The overall length of hospital stay was a day less in study group (7.5 days in study group vs. 8.4 days in control group).
Conclusion
Routine use of drains in not required in all cases of gynaecological cancer surgery. Case-to-case base approach of using drain can be done without any increase in post-operative complications.
Similar content being viewed by others
References
Piovano E, Ferrero A, Zola P, Christain Marth, Mirza MR, Lindermann K. Clinical pathways of recovery after surgery for advanced ovarian/tubal/peritoneal cancer: an NSGO-MaNGO international survey in collaboration with AGO-a focus on surgical aspects. Int J Gynecol Cancer. 2019;29:181–7.
Nelson G, Bakkum-Gamez J, Kalogera E, Glaser G, Altman A, Meyer LA, Taylor JS. Guidelines for perioperative care in gynecologic/oncology: enhanced recovery after surgery(ERAS) society recommendations-2019 update. Int J Gynecol Cancer. 2019;29(4):651–68.
Puleo FJ, Mishra N, Hall JF. Use of intra-abdominal drains. Clin Colon Rectal Surg. 2013;26(3):174–7.
Shrikhande SV, Barreto SG, Shetty G, Suradkar K, Bodhankar YD, Shah SB, et al. Post-operative abdominal drainage following major upper gastrointestinal surgery: single drain versus two drains. J Cancer Res Ther. 2013;9(2):267–71.
Shepherd JH, Crowther ME. Complications of gynaecological cancer surgery: a review. J R Soc Med. 1986;79(5):289–93.
Franchi M, Trimbos JB, Zanaboni F, Velden J, Reed N, Coens C, et al. Randomised trial of drains vs no drain following radical hysterectomy and pelvic lymph node dissection: a European organisation for research and treatment of cancer—gynaecological cancer group (EORTC-GCG) study in 234 patients. European Journal of Cancer. 2007;43(8):1265–8.
Charoenkwan K, Kietpeerakool C. Retroperitoneal drainage versus no drainage after pelvic lymphadenectomy for the prevention of lymphocyst formation in women with gynaecological malignancies. Cochrane Database Syst Rev. 2017;6:CD007387.
Owens CD, Stoessel K. Surgical site infections: epidemiology, microbiology and prevention. J Hosp Infect. 2008;70(Suppl 2):3–10.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of survey. Ann Surg. 2004;240:205–13.
Novetsky AP, Zighelboim I, Guntupalli SR, Ioffe YJ, Kizer NT, Hagemann AR, et al. A phase II trial of a surgical protocol to decrease the incidence of wound complications in obese gynaecologic oncology patients. Gynecol Oncol. 2014;134(2):233–7.
Fujii T, Tabe Y, Yajima R, Yamaguchi S, Tsutsumi S, Asao T, et al. Effects of subcutaneous drain for the prevention of incisional SSI in high risk patients undergoing colorectal surgery. Int J Colorectal Dis. 2011;26(9):1151–2.
Baier PK, Gluck NC, Baumgartner U, Adam U, Fischer A, Hopt UT. Subcutaneous redon drains do not reduce the incidence of surgical site infections after laparotomy. A randomized controlled trial in 200 patients. Int J Colorectal Dis. 2010;25(5):639–43.
Manzoor B, Heywood N, Sharma A. Review of subcutaneous wound drainage in reducing surgical site infections after laparotomy. Surg Res Pract. 2015;2015:715803.
Watanabe J, Ota M, Kawamoto M, Akikazu Y, Suwa Y, Suwa H, et al. A randomized controlled trial of subcutaneous closed-suction Blake drains for the prevention of incisional surgical site infection after colorectal surgery. Int J Colorectal Dis. 2017;32(3):391–8.
Ochiai K, Kaneko M, Nozawa H, Kawai K, Hata K, Tanaka T, et al. Incidence of and risk factors for lymphocele formation after lateral pelvic lymph node dissection for rectal cancer: a retrospective study. Colorectal Dis. 2020;22(2):161–9.
Funding
No internal or external funding was availed for this study.
Author information
Authors and Affiliations
Contributions
Dr. Sumeet Jain, Dr. Akashdeep Singh Sohi and Dr. G. S. Brar were involved in performing procedures and maintaining data base. All four authors were involved in writing and reviewing the manuscript.
Corresponding author
Ethics declarations
Conflicts of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Jain, S., Sohi, A.S., Brar, G.S. et al. An Observational Study to Compare Use of Drains Versus No Drains After Gynaecology Oncology Surgery at a Tertiary Care Centre. Indian J Gynecol Oncolog 18, 53 (2020). https://doi.org/10.1007/s40944-020-00400-z
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s40944-020-00400-z